Training the Next Generation of Primary Care Doctors Act of 2019

II 116TH CONGRESS 1ST SESSION S. 1191 To reauthorize section 340H of the Public Health Service Act to continue to encourage the expansion, maintenance, and establishment of approved graduate medical residency programs at qualified teaching health centers, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL 11, 2019 Ms. COLLINS (for herself, Mr. TESTER, Mrs. CAPITO, Mr. JONES, Mr. BOOZ- MAN, Mr. MANCHIN, Mr. DAINES, and Ms. HARRIS) introduced the fol- lowing bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To reauthorize section 340H of the Public Health Service Act to continue to encourage the expansion, maintenance, and establishment of approved graduate medical resi- dency programs at qualified teaching health centers, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Training the Next 4 Generation of Primary Care Doctors Act of 2019’’. 5 VerDate Sep 11 2014 03:54 Apr 20, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1191.IS S1191 kjohnson on DSK79L0C42 with BILLS 2 •S 1191 IS SEC. 2. FINDINGS. 1 Congress finds as follows: 2 (1) The program of payments to teaching 3 health centers for graduate medical education under 4 section 340H of the Public Health Service Act (42 5 U.S.C. 256h) was enacted in 2010 and reauthorized 6 in 2015 and 2018 to address the crisis-level shortage 7 of primary care physicians, especially in rural and 8 medically underserved communities. 9 (2) Teaching health center residents and faculty 10 will provide more than 1,000,000 primary care med- 11 ical visits in 2019 to underserved communities. 12 (3) When compared with traditional Medicare 13 GME residents, residents who train at teaching 14 health centers are more likely to practice primary 15 care and remain in underserved or rural commu- 16 nities. 17 (4) The teaching health center program not 18 only plays a vital role in training the Nation’s next 19 generation of primary care physicians (including 20 dentists), but helps bridge the Nation’s physician 21 shortfall and address the maldistribution of physi- 22 cians across the United States. 23 (5) For these reasons, it is of vital importance 24 to continue the program under section 340H of the 25 Public Health Service Act (42 U.S.C. 256h) at a 26 VerDate Sep 11 2014 03:54 Apr 20, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1191.IS S1191 kjohnson on DSK79L0C42 with BILLS 3 •S 1191 IS sustainable level of funding per full-time equivalent 1 resident, as recommended in the fact sheet of the 2 Health Resources and Services Administration enti- 3 tled ‘‘Cost Estimates for Training Residents in a 4 Teaching Health Center’’. 5 SEC. 3. PAYMENTS. 6 (a) IN GENERAL.—Subsection (g) of section 340H of 7 the Public Health Service Act (42 U.S.C. 256h(g)) is 8 amended— 9 (1) by redesignating paragraph (2) as para- 10 graph (4); and 11 (2) by inserting after paragraph (1) the fol- 12 lowing: 13 ‘‘(2) PAYMENTS TO APPROVED GRADUATE MED- 14 ICAL RESIDENCY TRAINING PROGRAMS.—To carry 15 out this section, for payments to approved graduate 16 medical residency programs (as defined in paragraph 17 (j)(1) of this section), there are appropriated 18 $126,500,000 for fiscal year 2020, $128,000,000 for 19 fiscal year 2021, $129,500,000 for fiscal year 2022, 20 $131,000,000 for fiscal year 2023, and 21 $132,500,000 for fiscal year 2024, to remain avail- 22 able until expended. 23 ‘‘(3) PAYMENTS TO NEW APPROVED GRADUATE 24 MEDICAL RESIDENCY TRAINING PROGRAMS.—To 25 VerDate Sep 11 2014 03:54 Apr 20, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1191.IS S1191 kjohnson on DSK79L0C42 with BILLS 4 •S 1191 IS carry out this section, for payments to new approved 1 graduate medical residency training programs (as 2 defined in paragraph (j)(2) of this section), there are 3 appropriated $6,000,000 for fiscal year 2021, 4 $12,000,000 for fiscal year 2022, $17,000,000 for 5 fiscal year 2023, and $25,000,000 for fiscal year 6 2024, to remain available until expended.’’. 7 (b) NUMBER OF RESIDENTS.—In calculating the 8 level of payments to each approved graduate medical resi- 9 dency training program pursuant to paragraph (g)(2) of 10 section 340H of the Public Health Service Act (42 U.S.C. 11 256h), the Secretary of Health and Human Services shall 12 pay for the number of residents at a program at a number 13 that is no lower than the highest number of residents in 14 their programs for the period of fiscal years 2016 through 15 2018. 16 (c) LIMITATIONS.—The number of full-time equiva- 17 lent residents for which a qualified teaching health center 18 receives payments pursuant to subparagraph (a)(1)(C) of 19 section 340H of the Public Health Service Act (42 U.S.C. 20 256h) for a fiscal year shall not exceed by more than 6 21 the number of full-time equivalent residents for which the 22 center received such payments for the preceding fiscal 23 year. 24 VerDate Sep 11 2014 03:54 Apr 20, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1191.IS S1191 kjohnson on DSK79L0C42 with BILLS 5 •S 1191 IS (d) REPORT ON EXPANSION.—Not later than Sep- 1 tember 30, 2021, the Secretary of Health and Human 2 Services shall submit to the Congress a report on the es- 3 tablishment of new approved graduate medical residency 4 programs and expansion of existing approved graduate 5 medical residency programs. The report shall include the 6 locations of such programs, the number of residents, and 7 statistics regarding the number of programs receiving pri- 8 ority under paragraph (a)(3) of section 340H of the Pub- 9 lic Health Service Act (42 U.S.C. 256h). 10 (e) PUBLIC AVAILABILITY OF DATA.—The Secretary 11 of Health and Human Services shall make available to the 12 public the data reported by qualified teaching health cen- 13 ters pursuant to subsection (d) of this section and para- 14 graph (h)(1) of section 340H of the Public Health Service 15 Act (42 U.S.C. 256(h)). 16 Æ VerDate Sep 11 2014 03:54 Apr 20, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S1191.IS S1191 kjohnson on DSK79L0C42 with BILLS